Showing papers in "Health Sociology Review in 2022"
TL;DR: After listening to the podcast, doctors reported attitudinal and behavioural changes which led to stereotypes being overturned and more culturally competent care delivery, and this pilot is embedded in a Participatory Action Research study which explores strategies to improve culturally safe communication at the main NT hospital Royal Darwin Hospital.
Abstract: ABSTRACT In Australia’s Northern Territory (NT) most people who access health services are Aboriginal and most healthcare providers are non-Indigenous; many providers struggle to deliver culturally competent care. Cultural awareness training is offered however, dissatisfaction exists with the limited scope of training and the face-to-face or online delivery format. Therefore, we developed and evaluated Ask the Specialist: Larrakia, Tiwi and Yolŋu stories to inspire better healthcare, a cultural education podcast in which Aboriginal leaders of Larrakia, Tiwi and Yolŋu nations, known as the Specialists, answer doctors’ questions about working with Aboriginal patients. The Specialists offer ‘counterstories’ which encourage the development of critical consciousness thereby challenging racist narratives in healthcare. After listening to the podcast, doctors reported attitudinal and behavioural changes which led to stereotypes being overturned and more culturally competent care delivery. While the podcast was purposefully local, issues raised had applicability beyond the NT and outside of healthcare. Our approach was shaped by cultural safety, critical race theory and Freirean pedagogy. This pilot is embedded in a Participatory Action Research study which explores strategies to improve culturally safe communication at the main NT hospital Royal Darwin Hospital.
5 citations
TL;DR: The qualitative research outlined in this paper was a collaboration between a mainstream residential therapeutic community program and two Aboriginal community-controlled organisations, and Aboriginal young people and researchers, with Aboriginal research leadership, with an Aboriginal healing framework to understand the experiences of 12 young Aboriginal people in the program, triangulated with 19 key informant interviews.
Abstract: ABSTRACT Disproportionately high numbers of Aboriginal young people access residential alcohol and other drug programs in Australia. While demand is high, these programs often have low numbers of Aboriginal staff. Residential programs, however, generally offer supports that reflect features of Aboriginal health care – holistic, group-based, connected to local communities, and addressing determinants of health. The qualitative research outlined in this paper was a collaboration between a mainstream residential therapeutic community program and two Aboriginal community-controlled organisations, and Aboriginal young people and researchers, with Aboriginal research leadership. It used an Aboriginal healing framework to understand the experiences of 12 young Aboriginal people in the program, triangulated with 19 key informant interviews. This provided an opportunity to understand how Indigenous knowledge about healing related to mainstream programs and the experiences of Aboriginal young people. This moves beyond individualist and deficit-focused conceptions of youth alcohol and drug use and centres Aboriginal cultures as healing. Findings point to the need for critically self-reflective mainstream organisations, a larger Aboriginal workforce with leadership roles, partnerships with Aboriginal Elders and organisations, and an investment in Aboriginal community-controlled alcohol and other drug services.
4 citations
TL;DR: In this paper , the authors report on a three-year participatory action research (PAR) project conducted on Whadjuk Nyoongar country in Perth, Western Australia, focusing on key components that both inform and assist service providers in improving service provision to Aboriginal young people.
Abstract: ABSTRACT Mainstream youth mental health services struggle to comprehend the connection between colonisation and service provision for Aboriginal young people. This is the consensus agreed by Aboriginal Elders from Perth, Western Australia and young Aboriginal leaders within their communities (Wright, Culbong, Crisp, Biedermann, & Lin (2019). 1–7). What is required is a more nuanced, culturally relevant approach to both an understanding of the impact of colonisation on mental health and help-seeking behaviour if they are to provide equitable access for Aboriginal young people. In this paper, we report on a three-year participatory action research (PAR) project conducted on Whadjuk Nyoongar country in Perth, Western Australia. An innovative model of care framework developed from the project and described in this paper, focuses on key components that both inform and assist service providers in improving service provision to Aboriginal young people. The model, depicted as a tree, symbolises strength and growth, with the ‘roots’ of the tree, holding trust, culture and spirit. This paper details a culturally-safe co-design process that was held and directed with Elders, in partnership with young people, youth mental health service staff and youth policy staff.
3 citations
TL;DR: Wang et al. as discussed by the authors conducted a multistage survey among household heads from China and measured the quantity and monetary values of outgoing and incoming gift cigarettes circulated by each household and measured social capital in three dimensions: collective participation, social ties, and trust.
Abstract: ABSTRACT The widespread exchange of tobacco cigarettes as a gift in some societies normalises the symbolic desirability of tobacco products and promotes smoking. Little is known about how and why people exchange toxic substances as gifts. This study argues two key factors involved in social exchange processes – reciprocity and social capital – can explain gift cigarette circulation. We conducted a multistage survey among household heads from China and measured the quantity and monetary values of outgoing and incoming gift cigarettes circulated by each household and measured social capital in three dimensions: collective participation, social ties, and trust. Ordinary Least Square regressions showed that reciprocity is strongly and significantly associated with both the value and quantity of gift cigarettes. All three dimensions of social capital are varyingly associated with gifting cigarettes. Income and higher classes are also associated with greater quantity and value of received cigarettes. This study broadens the phenomenon of gifting cigarettes to the more universal patterns of reciprocity and social capital, wherein better social capital and socioeconomic position ironically lead to a higher risk of tobacco use and endanger health. We suggest policymakers target the endemic social need for gift exchange in China’s informal economy.
3 citations
TL;DR: The Yuwinbir Special Issue of Health Sociology Review as mentioned in this paper explores meeting points between health sociology and Indigenous knowledges, and highlights the way that conscious, critically reflective enquiry about self and sovereignty could transform relationships between Indigenous people and health sociology.
Abstract: We acknowledge the Gadigal and Wangal people of the Eora Nation, Dabee people of the Wiradjuri Nation, and Wurundgeri Woi Wurrung and Bunurong Boon Wurrung peoples of the Kulin Nation, whose lands have supported the leadership of this Yuwinbir Special Issue of Health Sociology Review. We acknowledge their ancestors, spirits and knowledges, Elders of the past, and Elders of the present. We acknowledge Indigenous people who shaped each article and extend our thanks to their collaborators in exploring meeting points between health sociology and Indigenous knowledges. While ‘meeting points’ is the theme of this issue, we offer a critique of it in the editorial below. We respectfully use the Wiradjuri word ‘Yuwinbir’ to name this special issue, signalling ‘this way’ (Grant & Rudder, 2010) health sociology: this is the way Indigenous authors cited here say we must go. While our editorial names some distressing knowledge and research practice traps to dismantle along the way, it also outlines the way that conscious, critically reflective enquiry about self and sovereignty could transform relationships between Indigenous people and health sociology. The development of the Yuwinbir special issue grew from guest co-editor MeganWilliams’ experience as an associate editor of Health Sociology Review and related to Megan’s role as Chief Investigator of the Centre for Research Excellence – Strengthening systems for InDigenous health care Equity (CRE-STRIDE). CRE-STRIDE builds on 15 years of efforts from a large number of collaborators to improve the quality of health research particularly in partnership with Aboriginal and Torres Strait Islander community controlled health organisations. CRE-STRIDE was established to address health inequity using Indigenous knowledges. It has Indigenous people’s leadership across multi-level project governance structures. An Indigenous Research Framework guides community engagement in research and research on wellbeing, health systems and service quality improvement processes. Relationality and relationships are central, with supportive project structures, and an ‘all teach, all learn’ capacity strengthening commitment that is continuous, reciprocal and reflexive (CRESTRIDE, 2020). The applied health research for health equity that CRE-STRIDE progresses has much to do with health sociology. Some CRE-STRIDE collaborators are trained in social sciences and sociology and for Megan this combines with training in Indigenous knowledges and public health. Belonging to Wiradjuri and palawa peoples and with Anglo-Celtic heritage, Megan’s work is multi-disciplinary across health and justice fields, focusing on the health of Aboriginal people in prison and reforms (Finlay, Williams, Sweet, McInerney, & Ward, 2016; Williams, 2021a). Co-editor Dr Demelza Marlin was trained in sociology and developed experience in health from her research on the intersections between culture, community, sports leadership and physical activity in Aboriginal and Torres Strait Islander contexts (Marlin, Apoifis, & Bennie, 2020). She has also investigated the relationship between wellbeing and everyday ritual and connections to place in non-Indigenous contexts (Game, Metcalfe, & Marlin,
2 citations
TL;DR: The analysis of qualitative interviews with 28 GPs and 13 pharmaceutical sales representatives (PSRs) showed that GPs, through prescribing medicines, met pharmaceutical sales targets in exchange for various incentives as discussed by the authors .
Abstract: ABSTRACT Incentivisation of general practitioners (GPs) by pharmaceutical companies is thought to affect prescribing practices, often not in patients’ interest. Using a Bourdieusian lens, we examine the socially structured conditions that underpin exchanges between pharmaceutical companies and GPs in Pakistan. The analysis of qualitative interviews with 28 GPs and 13 pharmaceutical sales representatives (PSRs) shows that GPs, through prescribing medicines, met pharmaceutical sales targets in exchange for various incentives. We argue that these practices can be given meaning through the concept of ‘field’ – a social space in which GPs, PSRs, and pharmacists were hierarchically positioned, with their unique capacities, to enable healthcare provision. However, structural forces like the intense competition between pharmaceutical companies, the presence of unqualified healthcare providers in the healthcare market, and a lack of regulation by the state institutions produced a context that enabled pharmaceutical companies and GPs to use the healthcare field, also, as space to maximise profits. GPs believed the effort to maximise incomes and meet socially desired standards were two key factors that encouraged profit-led prescribing. We conclude that understanding the healthcare field is an important step toward developing governance practices that can address profit-led prescribing.
1 citations
TL;DR: In this article , the authors examined inequality empirically by combing framing field structures with the classed abilities of families to mobilise capital after a severe acquired brain injury (severe ABI).
Abstract: ABSTRACT Inequalities in illness, service provision, and outcomes are well documented in the Nordic universal welfare state. The ways in which inequalities are produced during illness recovery trajectories remain largely unknown. Long-term brain injury rehabilitation in this context provides a window into veiled aspects of inequality and the underlying mechanisms. We examine inequality empirically by combing framing field structures with the classed abilities of families to mobilise capital after a severe acquired brain injury (severe ABI). Using a Bourdieuan theoretical framework, informed by the concepts of field, doxa, cultural health capital (CHC), and rehabilitation capital (RC), we designed a longitudinal case study encompassing professional records, observations, and interviews that tracked and analysed subjects' trajectories. We found that families’ consistent accumulation and conversion of capital was crucial after a severe ABI because of the multifaceted rehabilitation process involving many different field specific agendas and doxas. This study supplements previous concepts (CHC and RC) developed in a health care context by including other rehabilitation contexts. These disparities in forms of capital amongst social classes result in winners and losers and were reflected in the rehabilitation trajectories of the young adults, characterised by continuity on one extreme and broken trajectories on the other.
1 citations
TL;DR: A qualitative sociological study, using semi-structured interviews, was conducted with 40 children, aged from 9 to 11 years, from four French elementary schools and found that children from disadvantaged social backgrounds mentioned less foods, seemed to have a less varied diet, to consume less vegetables, and to enjoy eating ultra-processed foods more than other children as discussed by the authors .
Abstract: ABSTRACT The diet of individuals is influenced by social and cultural factors. Children’s food tastes and representations, being principally transmitted by their parents, are likely to depend on their social backgrounds. As it is known that parents’ feeding strategies and food education differ depending on their social positions, this study aimed at examining how food representations and tastes vary among children. A qualitative sociological study, using semi-structured interviews, was conducted with 40 children, aged from 9 to 11 years, from four French elementary schools. Results showed that children from disadvantaged social backgrounds mentioned less foods, seemed to have a less varied diet, to consume less vegetables, and to enjoy eating ultra-processed foods more than other children. Different food habitus were found, that can be put into perspective using Bourdieu’s distinction theory, including different preoccupations regarding health and necessity among social groups. Disparities in children's food habitus could be theoretically linked with observed and growing social inequalities in health, when taking into consideration the potential practises that these habitus imply, and their probable effects on health. Participatory food education classes at school could aim to reduce such disparities, although some concerns and limits must be acknowledged.
1 citations
TL;DR: In this article , the authors explored Indigenous knowledges of sexual, reproductive health and motherhood shared by Basotho women and used decolonial African feminist approaches to challenge the assumed universality of conceptions of sexual and reproductive health that are both deeply embedded and produced within specific relations of power.
Abstract: ABSTRACT Indigenous knowledge systems embody a holistic, inclusive view of the world and foreground interconnectedness for the promotion of life. Through reflective engagement with the author’s positioning as an Indigenous researcher, this article explores Indigenous knowledges of sexual, reproductive health and motherhood shared by Basotho women. It draws on the life stories of twenty never-married women and uses decolonial African feminist approaches to challenge the assumed universality of conceptions of sexual and reproductive health that are both deeply embedded and produced within specific relations of power. It illuminates the Indigenous pitiki space as an Indigenous knowledge hub purposed to empower Basotho women’s sexual and reproductive health. Within this space, Indigenous knowledges and skills are shared amongst women, with the elderly imparting knowledges to the young women. In the context of unsurmountable health disparities, the article shows how Indigenous knowledge-sharing outside the exclusive ‘westernised’ health systems enables communal support for the well-being of women and children in African contexts. It emphasises the need for inclusive and expansive knowledge production systems not only to better inform equitable health solutions for Indigenous communities but also for epistemic redress in the discipline of Sociology.
1 citations
TL;DR: In a qualitative study on masculinity, embodiment and sexuality, this article interviewed men who were recreational gym-goers about their bodywork practices in Melbourne, Australia and found that participants held varying opinions on PIED use and those who used them.
Abstract: In a qualitative study on masculinity, embodiment and sexuality, we interviewed men who were recreational gym-goers about their bodywork practices in Melbourne, Australia. We also asked whether the men had used performance and image-enhancing drugs (PIEDs) as an adjunct to their bodywork practices. While none had used PIEDs, all were considering, or had considered, using them. We found that participants held varying opinions on PIED use and those who used them. The literature on PIEDs noted men’s concerns with body appearance and health and focused largely on individual problematic use, but non-users were not mentioned. A second issue in the literature focused on social influences on PIED use, but again with no mention of non-users. Discussion on risk reduction as a public health response did not mention non-users either. This paper, therefore, reports on non-users’ thoughts on, regular exposure to, and considerations of PIEDs and other men who use them. We propose that PIEDs might more usefully be understood as an everyday, if contradictory, consideration within most men’s bodywork and health practices. We argue that PIEDs constitute a discursive practice exposing a potentiality that engages non-users also and this requires new health promotion approaches.
TL;DR: Qualitative interviews with 20 key informants working in various professional capacities in health, social policy, care and advocacy sectors in Australia explore their experiences and perspectives on family inclusivity in their services and draw on qualitative interviews with key informants acknowledged the diversity of what constitutes family.
Abstract: ABSTRACT In recognition of the broader relational aspects of viral infections, family support is considered important when someone is diagnosed with a blood-borne virus (BBV), such as HIV, hepatitis C (HCV) and hepatitis B (HBV). However, families’ own support needs are often not a priority in service provision within the BBV sector. In this article, we draw on qualitative interviews with 20 key informants working in various professional capacities in health, social policy, care and advocacy sectors in Australia, and explore their experiences and perspectives on family inclusivity in their services. Overall, key informants acknowledged the diversity of what constitutes family, and consistently viewed family engagement as beneficial to both diagnosed individuals and the wider familial networks affected by a diagnosis. However, prioritising individual care in support services presented barriers to engaging families, which are further complicated by the role of stigma in shaping the social realities of living with a BBV. Increasing understanding in service provision settings that serodiscordance can be a family experience has the potential to widen this analytic lens to consider the support needs of families in their own right.
TL;DR: In this article , the authors identify four themes that reveal different aspects of professional identity: conceptualising professional identity, professional identity as a title and legislative requirement; professional identities as qualifications and training; and professional performance as a social performance.
Abstract: ABSTRACT Historical sociological perspectives posit professional identity to emerge from socialisation and attainment of ‘traits’ considered unique to and distinguishing of a profession. Such essentialist understandings, however, cannot account for group heterogeneity, nurses’ lived experiences, nor the fluidity of professional and personal identity. This article conceptualises professional identity as being both individual and collective, influenced by context, involving subjective meaning-making, and membership to a specific professional group. Drawing on ethnographic data gathered through participant observation and semi-structured interviews with Critical Care Nurses in an Intensive Care Unit in regional Australia, we identify four themes that reveal different aspects of professional identity: conceptualising professional identity; professional identity as a title and legislative requirement; professional identity as qualifications and training; and professional identity as a social performance. The findings demonstrate that Critical Care Nurses hold multifaceted perceptions of professional identity. While they collectively distinguish their nursing training, knowledge, and practice from other nurses, they struggle to articulate what professional identity is, while creating boundaries between different forms of nursing education and qualifications to construct their professional identity. These uncertain and diverse meanings of professional identity contribute to nurse identity ambiguity, while also reflecting the necessity of flexible individual and collective nursing identities.
TL;DR: In this article , the authors examined the association between educational attainment, relative to that of an intimate partner, and all-cause mortality for men and women in different-sex relationships.
Abstract: ABSTRACT This study examines the association between educational attainment, relative to that of an intimate partner, and all-cause mortality for men and women in different-sex relationships. Research suggests some health benefits for partnered adults that arise from economic benefits and improved access to health-promoting tools. One way these benefits could be gained is through the pairing of the highly educated. While high individual educational attainment lowers mortality risk, less is known about the risks of mortality associated with one’s education, relative to their partner’s education. Using National Health Interview Survey Linked Mortality Files (NHIS-LMF) for the years 1999–2014 with prospective mortality follow-up through December 2015 (N = 347,994), we document the association between relative educational attainment and mortality for men and women with different-sex partners in the United States. Fully adjusted Cox proportional hazard models revealed a higher risk of all-cause mortality for men and women who have more education than their partner, relative to those having the same education as their partner. For women only, having less education than their male partner was associated with a lower risk of all-cause mortality. A better understanding of relative status within different-sex partnerships provides insights into partnered adult’s mortality risks.
TL;DR: It is observed that objective and subjective cohesion forms have different effects on health record establishment and health education receipt, and the positive effect of objective cohesion on health services utilisation is significantly larger than that of subjective cohesion.
Abstract: ABSTRACT Social cohesion and socioeconomic status (SES) have been widely considered important factors influencing health services utilisation, but little is known about the association between social cohesion and health services utilisation across different SES groups. Based on a nationally representative survey, this study explores the influence of social cohesion on basic public health services utilisation in Chinese internal migrants at different SES levels. It is observed that objective and subjective cohesion forms have different effects on health record establishment and health education receipt. The positive effect of objective cohesion on health services utilisation is significantly larger than that of subjective cohesion, but two cohesion forms show similar effect sizes on health services utilisation among poor-SES migrants. With the promotion of SES, the effect size of objective cohesion gradually increases while that of subjective cohesion declines, showing a distribution of ‘scissors gap'. For basic public health services utilisation, migrants not only have the agency to receive but are constrained by their SES. For migrants with poor SES, strong structural constraints hinder the utilisation of basic public health services.
TL;DR: In this article , the authors explored the contexts, processes and motivations behind the administration of sedatives (minor tranquilisers) in the time around perinatal loss and found that sedative administration was associated with emotional control and avoidance of loss, lack of accompaniment and on occasion with managing disruptive patients.
Abstract: ABSTRACT This article explores the contexts, processes and motivations behind the administration of sedatives (minor tranquilisers) in the time around perinatal loss. Using a mixed methods design, an online survey of 796 women and 13 narrative interviews were conducted. The participants had experienced a stillbirth or termination of pregnancy from 16 weeks or a neonatal death in Spanish hospitals. The quantitative (univariate and CHAID decision-tree) and qualitative (narrative-linguistic) analysis found that sedative administration was pervasive across care contexts and appears to be naturalised despite contradicting practice recommendations. Sedative administration was associated with emotional control and avoidance of loss, lack of accompaniment and on occasion with managing disruptive patients. Lack of informed consent was very common, with little explanation of side-effects prior to administration. In the participants’ narratives, health professionals tended to construct sedatives as benign, but for some women the effects were counterproductive to loss and grief and related to persistent regrets about decisions. The study concludes that, in the context of perinatal loss, sedative administration was highly integrated into the fabric of medicalised care. As a socio-political and cultural practice underscored by gender-based care dynamics, there seems to be an imbalance between benefit and risk to women’s welfare.
TL;DR: It is demonstrated how China’s socio-cultural environment shapes assumptions about the risk of lung cancer with particular reference to work, home, social situations, and the natural environment.
Abstract: ABSTRACT Rates of lung cancer in China are rising rapidly, creating an urgent need for prevention. Effective prevention measures require understanding local beliefs and perceptions about the risk for developing lung cancer. This article explores the explanations that Chinese lung cancer patients and their families give about the aetiology of their disease. Fifty-three interviews were conducted among lung cancer patients and their family members at a large tumour hospital in southern China. Participants presented a complex multifactorial explanation of lung cancer associating their disease with risks like tobacco use, occupational exposures, environmental pollution, lifestyle changes, and personal characters. While these are all standard risk factors commonly associated with lung cancer, participants presented them within a larger contextual frame of structural issues that impede their ability to change their behaviours. Using a social ecological model, we demonstrate how China’s socio-cultural environment shapes assumptions about the risk of lung cancer with particular reference to work, home, social situations, and the natural environment.